Donald Trump (voice snippet) believes that the US will not need 40.000 ventilators, and hospitals will be fine with one or two.
Never laughed so hysterically in my life.
https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?source=history_widgetTransmission of SARS-CoV-2 from asymptomatic individuals (or individuals within the incubation period) has also been described [23-27]. However, the extent to which this occurs remains unknown. Large-scale serologic screening may be able to provide a better sense of the scope of asymptomatic infections and inform epidemiologic analysis; several serologic tests for SARS-CoV-2 are under development [28].
Chinese researchers had previously suggested asymptomatic people might transmit the virus but had not presented clear-cut evidence. “There’s no doubt after reading [the NEJM] paper that asymptomatic transmission is occurring,” Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told journalists. “This study lays the question to rest.”
But now, it turns out that information was wrong. The Robert Koch Institute (RKI), the German government’s public health agency, has written a letter to NEJM to set the record straight, even though it was not involved in the paper.
src: https://www.sciencemag.org/news/2020/02/paper-non-symptomatic-patient-transmitting-coronavirus-wrongThe letter in NEJM described a cluster of infections that began after a businesswoman from Shanghai visited a company near Munich on 20 and 21 January, where she had a meeting with the first of four people who later fell ill. Crucially, she wasn’t sick at the time: “During her stay, she had been well with no sign or symptoms of infection but had become ill on her flight back to China,” the authors wrote. “The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak.”
But the researchers didn’t actually speak to the woman before they published the paper. The last author, Michael Hoelscher of the Ludwig Maximilian University of Munich Medical Center, says the paper relied on information from the four other patients: “They told us that the patient from China did not appear to have any symptoms.” Afterward, however, RKI and the Health and Food Safety Authority of the state of Bavaria did talk to the Shanghai patient on the phone, and it turned out she did have symptoms while in Germany. According to people familiar with the call, she felt tired, suffered from muscle pain, and took paracetamol, a fever-lowering medication. (An RKI spokesperson would only confirm to Science that the woman had symptoms.)
Hoelscher was not on the call, he says. “I asked the Bavarian Health and Food Safety Authority whether the information from that phone conversation called for a correction and I was told that is not the case,” he says. (The Bavarian ministry of health, of which the agency is part, has not responded to a request for information from ScienceInsider.) But RKI disagreed. The agency’s spokesperson confirms that a letter about the error has been submitted to NEJM. RKI also informed the World Health Organization (WHO) and European partner agencies about the new information.
“I feel bad about how this went, but I don’t think anybody is at fault here,” says virologist Christian Drosten of the Charité University Hospital in Berlin, who did the lab work for the study and is one of its authors. “Apparently the woman could not be reached at first and people felt this had to be communicated quickly.”
The Public Health Agency of Sweden reacted less charitably. “The sources that claimed that the coronavirus would infect during the incubation period lack scientific support for this analysis in their articles,” says a document with frequently asked questions the agency posted on its website yesterday. “This applies, among other things, to an article in [NEJM] that has subsequently proven to contain major flaws and errors.” Even if the patient’s symptoms were unspecific, it wasn’t an asymptomatic infection, says Isaac Bogoch, an infectious disease specialist at the University of Toronto. “Asymptomatic means no symptoms, zero. It means you feel fine. We have to be careful with our words.”
Hoelscher agrees that the paper should have been clearer about the origin of the information about the woman’s health. “If I was writing this today, I would phrase that differently,” he says. The need to share information as fast as possible, along with NEJM’s push to publish early, created a lot of pressure, he says.
The fact that the paper got it wrong doesn’t mean transmission from asymptomatic people doesn’t occur. Fauci, for one, still believes it does. "This evening I telephoned one of my colleagues in China who is a highly respected infectious diseases scientist and health official," he says. "He said that he is convinced that there is asymptomatic infection and that some asymptomatic people are transmitting infection." But even if they do, asymptomatic transmission likely plays a minor role in the epidemic overall, WHO says. People who cough or sneeze are more likely to spread the virus, the agency wrote in a situation report on Saturday. “More data may come out soon. We will just have to wait,” Lipsitch says.
src: https://www.ecdc.europa.eu/sites/de...f-novel-coronavirus-disease-2019-COVID-19.pdfTransmission in pre-symptomatic stage of infection: In addition to case reports, pre-symptomatic transmission has been inferred through modelling, and the proportion of pre-symptomatic transmission was estimated to be around 48% and 62% [41]. Pre-symptomatic transmission was deemed likely based on a shorter serial interval of COVID-19 (4.0 to 4.6 days) than the mean incubation period (five days) with the authors indicating that many secondary transmissions would have already occurred at the time when symptomatic cases are detected and isolated [42]. Major uncertainties remain in assessing the influence of pre-symptomatic transmission on the overall transmission dynamics of the pandemic.
In conclusion, we have estimated the median serial interval of COVID-19 at 4.0 days, which is close to or shorter than the disease’s median incubation period indicating that rapid cycles of transmission and substantial pre-symptomatic transmissions are occurring. Thus, containment via case isolation alone is likely to be very challenging.